Kwekkeboom D J, Reubi J C, Lamberts S W, Bruining H A, Mulder A H, Oei H Y, Krenning E P
Department of Nuclear Medicine, University Hospital Dijkzigt, Rotterdam, The Netherlands.
J Clin Endocrinol Metab. 1993 Jun;76(6):1413-7. doi: 10.1210/jcem.76.6.8501144.
Using in vivo scintigraphy with the 111In-labeled somatostatin analog octreotide, tumor localizations were demonstrated in 11 of 17 patients (65%) with medullary thyroid carcinoma (MTC). Tumor localizations in the liver in 7 patients, and in the thyroid in 1 patient were not detected on octreotide scintigraphy, most probably because of normal uptake of labeled octreotide in these organs. Specific somatostatin receptors were demonstrated in vitro on all 5 investigated tumors which had also been visualized in vivo, as well as on 1 tumor that was not. Immunohistochemically, somatostatin was present in 1 of 6 tumors that were visualized in vivo, and in neither of 2 tumors that were not. The ratio of serum calcitonin over carcino-embryonic antigen concentrations was significantly higher in patients whose MTCs were visualized during octreotide scintigraphy than in those whose tumors were not. We have formed the following conclusions: 1) In the majority of patients with metastatic MTC, tumor sites can be visualized using octreotide scintigraphy, although this technique is insensitive in detecting liver metastases or intrathyroidal tumor; 2) The visualization of MTC during in vivo somatostatin receptor imaging correlates with the in vitro presence of somatostatin receptors; 3) The immunohistochemical presence of somatostatin in the tumor does not seem to influence the outcome of in vivo somatostatin receptor imaging; and 4) Higher serum calcitonin over carcino-embryonic antigen ratios in patients whose MTC is visualized during octreotide scintigraphy might imply that somatostatin receptors are present on more differentiated MTC.
使用111In标记的生长抑素类似物奥曲肽进行体内闪烁扫描，在17例甲状腺髓样癌（MTC）患者中的11例（65%）显示出肿瘤定位。7例患者肝脏中的肿瘤定位以及1例患者甲状腺中的肿瘤定位在奥曲肽闪烁扫描中未被检测到，很可能是因为这些器官对标记奥曲肽的正常摄取。在所有5个在体内也被显影的研究肿瘤以及1个未被显影的肿瘤上，体外均证实存在特异性生长抑素受体。免疫组化显示，在6个在体内被显影的肿瘤中有1个存在生长抑素，而在2个未被显影的肿瘤中均未发现。奥曲肽闪烁扫描期间MTC被显影的患者血清降钙素与癌胚抗原浓度之比显著高于肿瘤未被显影的患者。我们得出了以下结论：1）在大多数转移性MTC患者中，尽管该技术在检测肝转移或甲状腺内肿瘤方面不敏感，但使用奥曲肽闪烁扫描可以显示肿瘤部位；2）体内生长抑素受体成像期间MTC的显影与体外生长抑素受体的存在相关；3）肿瘤中生长抑素免疫组化的存在似乎不影响体内生长抑素受体成像的结果；4）奥曲肽闪烁扫描期间MTC被显影的患者中血清降钙素与癌胚抗原的比例较高，这可能意味着在分化程度更高的MTC上存在生长抑素受体。
